# ALLEGIANCE GROUP DIVERSIFIED, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Allegiance Group At Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366678518
- **Authorized official:** MS. DENEEN ANNETTE PALMER (CHIEF OPERATIONS OFFICER)
- **Authorized official phone:** (703) 615-1974

## Contact information

- **Practice address:** 101 E HOLLY AVE, SUITE 4, STERLING, VA 20164-5402
- **Practice address phone:** (703) 615-1974
- **Practice address fax:** (703) 738-7009
- **Mailing address:** 101 E HOLLY AVE, SUITE 4, STERLING, VA 20164-5402
- **Mailing address phone:** (703) 615-1974
- **Mailing address fax:** (703) 738-7009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | B911896 | VA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | B911899 | VA | — |

## Other

- **Enumeration date:** 06/02/2009
- **Last updated:** 06/02/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | B911884 | BUSINESS PROFESSIONAL AND OCCUPATIONAL LICENSE | VA |
| 01 | — | B911896 | BUSINESS PROFESSIONAL AND OCCUPATIONAL LICENSE | VA |
| 01 | — | B911899 | BUSINESS PROFESSIONAL AND OCCUPATIONAL LICENSE | VA |